Right-Ventricular Enlargement in Arrhythmogenic Right-Ventricular Cardiomyopathy Is Associated with Decreased QRS Amplitudes and T-Wave Negativity

Background Arrhythmogenic right-ventricular cardiomyopathy (ARVC) can lead to RV dilatation. We hypothesized that electrocardiographic characteristics including QRS amplitudes in the extremity- and precordial leads, the S amplitude in lead V-1, and extent of T-wave negativity over the precordial leads are related to RV dilatation in this condition. MethodsIn 42 ARVC patients and 42 controls, we correlated total QRS amplitude in the extremity leads (Sigma QRS(ext)), precordial leads (Sigma QRS(prec)) and in all leads (Sigma QRS(tot) : summation of Sigma QRS(ext) and Sigma QRS(prec)), S amplitude in lead V-1 and the extent of T-wave inversion in the precordial leads (V-1 vs. beyond V-1) with RV end diastolic diameter (RVEDD) by echocardiography. ResultsIn the ARVC group, the mean age was 46 14 years, 31 patients were male, 28 had an implantable cardioverter defibrillator (ICD), and 7 had a LV ejection fraction (EF) <55%. The control group was age- and gender matched to the ARVC cohort. In contrast to controls, the Sigma QRS(ext) (regression coefficient (RC), -0.29; P = 0.020), Sigma QRS(prec) (RC, -0.20; P = 0.015), and Sigma QRS(tot) (RC, -0.14; P = 0.009) were lower with RV dilatation in ARVC. S amplitude in lead V-1 was not related to RV diameter (RC, -0.98; P = 0.088). Precordial T-wave inversion beyond lead V-1 (V-2-V-6) was associated with a larger RV diameter (RC, 8.58; P = 0.012). ConclusionsSummed QRS amplitudes in the extremity and precordial leads, and T-wave inversion beyond lead V-1 are associated with RV dilatation in patients with ARVC.